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L9 IS 'ON AV*1 610 -u n r ;110a A I D MEDICAL WASTE INSPECTION REPORT Date: San joaqWn-C.Quirity Environmental Health Depirtment Program 1868 E.Hazelton Ave.,Stockton, CA 96205 (209)468-3420 Record; SiOgy.0 rg/a hg Program Element, is ZY Facility Name Addross city Zip Code Windsor Elmhaven Care Center 6940 pacific avenue Stockton 95207 Facility Contact Tide PhOM0 Number Email Inspection Type Frank Juarez Maintenance Supervisor 209-477-4817 livarezOwIndsorc Routine ares,com The above facility Is Inspected for compliance with I)IvIslon 104,Part 14 Of California Health and Safety Code(HSC). Registration Treatment Cl I. HSC 117890-No LOG shall.genarale mai;Iicaf waste wrilass 1-115C 110130-All onsite medical waste treatment facilities shall— SC registered with the CA. be permitted by the EA. HSC 117950-LOG shall register with the EA prior to 2. generating medical waste. i El 18. HSC 118166-All treatment records shall be kept for 3 years. HSC 117903-Permit from the EA is required prior to treating 19, MSC 118216-All medical waste shall be treated pursuant to medical waste, this section. HSC 117926-SOG that treats medical waste onsite shall W 110220-PaftlOgY Waste of a human nature shall be 4. register with the EA. ❑ 20. 'disposed of by Interment,incineration,or an approved alternative. HSC 117900-Shall not haul medical waste unless registered, MSC 118222-Contaminated pathology waste,trace chemo ❑ 5, common carrier,.tra um a.sca"practitioner,or exempted ❑ 21. waiate,or pharm waste I'torn health care settings shall be treated under the MOT exemption. __1?1 Incineration or an a Roroved alternative. El 6. HSC 117928-Common Storage Facility shall have ❑ 22. 'HSC 119226-Sharps waste shall be treated pursuant to this iesurod by the EA, section. 7, HSC 11171190-LOG shall notify EA 72 hours prier to participating in temporary event. containmenii1storage El 8 HSC 117896-SOG shall notify EA 72 hours prior to 23. HSC 117630-Biohazard bag shall meet the standards set forth participating In terneorary event. In this section. HSC 118275-Medical,biohazardous,sharp5,trace chemo, Records/Documentation 24 pathology,or phormace4tical waste shall be segregated and contained pursuant to this section. The container shall be - pfoporN latow- El 9. HSC 117935-Registered SOO shall file MWMP with the.EA. ❑ 25. HSC I ism- Blohazard bags shall N containerized and stored pursuant to this.section, C] 10. HSC 117943-SQG required to register shall mairttaln ❑ 26. HSC 118985-Sherpa waste shall be contalnerized and stored treatment and shipping and tracking records for 3.years, pursuant to this section, 11, HSC 117945-SOG not requIred to register shall maintain 0 27. HSC 118206-Containors.shall be washed and decontaminated ❑ Information document and transpaAabon records for'3 years. pursuant to this section, 12, HSC 117960-LOG shall file MWMP with the EA. [J. 28. HSC II&306- Reuseabdo drums or conainters used for medical waste shall not be used for other storage. 13. HSC 117975-LQG Mall maintain treatment and shipping and Ei 29 HSC 11830,7- Intermediate storage area shall be secured and trucking documents for 2 years. marked with prow sigriage. Transportation ❑ 30- HSC 116310-Designated.accumulation area shall be secured and rnarl<ecl with proper Signa e. ❑ 14. HSC 117948-MOT exemption requirements for SOO, Other El 15. HSC 117976-MOT exemption requirements for LOG. ® 51- Unapproved use of biohazardous waste labels ❑ 16, HSC 118032-Pharmaceutical waste hauling exemption. 32. Reqelyod by; Print! Signature: Phone:209-4774817 Specialist: Print; J. Easter Signature: i Phone; 209-953-73-10 Reinspecion on/about: A reinspection fee of$132 per hour may be-charged. Page 1 of 3 EH-11/17